A trial of family therapy versus a relatives' group for schizophrenia. Two-year follow-up

The results are reported of a two-year follow-up of a trial of family sessions in the home (including patients) (12 families) versus a relatives' group (excluding patients) (11 families). Subjects were patients with schizophrenia living in high face-to-face contact with high-EE relatives. Patients were maintained on neuroleptic drugs for two years where possible. Relatives' critical comments and hostility were significantly lowered by nine months, but no significant changes occurred subsequently. Relatives' overinvolvement reduced steadily throughout the trial, and reduction in relatives' EE, either alone or in combination with reduced face-to-face contact, appeared to be associated with a lower relapse rate. The relapse rates for patients in the family-therapy and relatives'-group streams were 33% and 36% at two years. When these data were combined with the results of a previous trial, it was found that patients in families assigned to any form of social intervention had a two-year relapse rate of 40%, significantly lower than the 75% relapse rate for patients whose families were offered no help. We therefore recommend that relatives' groups are established in conjunction with some family sessions in the home for patients at high risk of relapse.